Active NPI
John Wikman, M.D.
- Surgery Physician
- Fort Smith, AR
National Provider Identifier
1871894493
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- C-2961
- Practice address
- 2400 Brigadoon Dr
Fort Smith, AR 72908-0911 - Phone
- (479) 648-3990
- NPI assigned
- Nov 12, 2010
- Last updated
- Nov 12, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | C-2961 | AR | Primary |
Addresses
Primary practice location
2400 Brigadoon Dr
Fort Smith, AR 72908-0911
Mailing address
2400 Brigadoon Dr
Fort Smith, AR 72908-0911
Phone (479) 648-3990
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C-2961 | AR | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289520000000",
"number": "1871894493",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 BRIGADOON DR",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729080911",
"telephone_number": "479-648-3990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 BRIGADOON DR",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729080911",
"telephone_number": "479-648-3990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIKMAN",
"first_name": "JOHN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-11-12",
"last_updated": "2010-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "AR",
"license": "C-2961",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Smith, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.